Macular Degeneration

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Macular
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Degeneration

Comprehensive, multi-disciplinary low vision

rehabilitation for people with vision loss
610 N. Main
Wichita, Kansas 67203
(316) 440-1600
Fax: (316) 267-9034
(316) 440-1660 en español
www.envisionrehab.com
What is Macular
Degeneration?

Age-related macular degeneration Prevalence of Age-Related Macular

Degeneration in United States
(AMD) is an eye disease that Ages 50 or older
affects central vision. It is caused (Number reflects percentage of population impacted)

by the deterioration of the macula, 5

4
the central part of the retina that is
3
essential for sharp, central vision.
2
It is here that visual information is
1
collected and then sent on to the
0
Non-Hispanic Non-Hispanic Hispanic/
brain for processing. Whites Blacks Latino
Americans

“I broke my wrist when I missed Source: 2008 Update: Prevent Blindness America Vision Problems in the US

the last step on my front porch and Macular degeneration affects 1.8
fell because I couldn’t see it. My million Americans, and is expected
eye doctor told me I have macular to increase to 2.9 million cases by
degeneration. She the year 2020.
was able to begin
treatment, Many people with vision loss have
and also blank spots, or scotomas, on their
referred me retinas. With macular degeneration,
for low vision the scotomas are near the macula,
rehabilitation so creating the frustrating loss of central
I can be safe vision that characterizes the disease.
in my own
home.”
“When macular degeneration began
stealing my vision, I was afraid I’d
have to move to a nursing home.
But low vision rehabilitation has
helped me remain in the home that
my husband and I have enjoyed
together for almost 40 years.”
Normal Vision Age-related
Macular Degeneration
Dry macular degeneration (non-
neovascular) accounts for 90 percent
of all cases of AMD. It occurs when
small deposits of drusen, a yellowish
material, accumulate on the macula.
The accumulation interferes with
the macula’s ability to sense light,
which leads to distortion and loss of
central vision. This accumulation may
begin as many as ten years before
you notice any vision loss, and its
progression is subtle and painless.
Wet macular degeneration
(neovascular) occurs when tiny,
abnormal blood vessels begin to grow
(neovascularization) behind the retina
near the macula. These vessels can
leak and damage the macula, leading Fundus image of a normal retina.

to rapid and sometimes severe vision

loss. Wet macular degeneration
almost always occurs in people
who already have dry macular
degeneration. If you ever experience
sudden changes in your vision,
Fundus image of a retina affected
you should see your eye doctor by macular degeneration.
immediately. You may also want to
look at an Amsler Grid every day to In occult wet macular degeneration,

watch for changes in your vision. new blood vessel growth beneath
the retina is not as pronounced, and
leakage is less evident, producing
less severe vision loss. Classic wet
macular degeneration leads to more
severe vision loss, produced by
very clear blood vessel growth and
Normal Vision Age-related
Macular Degeneration scarring beneath the retina.
Symptoms of
Macular Degeneration

• Painless loss of central vision

• Blurred vision
• Difficulty seeing fine details
clearly
• Straight lines may appear bent

Risk Factors for

Macular Degeneration

• Caucasian race
• Cigarette smoking
• Aging
• Family history
• Female gender
• Obesity
• Chronic kidney disease
• High blood pressure
• Lighter eye color
• Drug side effects
• Exposure to excessive sunlight
“Last spring, I noticed my mother’s
vision changing drastically. Out of
frustration, she stopped reading
the newspaper, and no longer kept
up with her letter writing. She said
it was just a part of aging. That
wasn’t enough for me. I took her
to see her eye doctor. Although
he couldn’t cure her macular
degeneration, he has helped her
slow down the progression of her
vision loss, and through low vision
rehabilitation, she’s regaining
confidence in some of her daily
living skills.”
How can I prevent
macular degeneration?
Prevention is mostly a matter of living exceed daily recommendations, you
a healthy lifestyle. Some studies have should consult your doctor before
shown that taking vitamins and eating following this program.
a diet rich in fruits and leafy green
You should lower your cholesterol,
vegetables can offer some protection
manage your blood pressure and
from dry macular degeneration.
avoid excessive alcohol use. Ultra-
A large-sample scientific study,
violet light protection is key, so
AREDS (Age-related Eye Disease
wearing sunglasses, tinted lenses in
Study), conducted by the National
your eyeglasses or a brimmed hat
Eye Institute, found that a specific
when outdoors is important.
combination of vitamins helped
AREDS Vitamin Recommendations:
slow the progression of macular • 500 milligrams of vitamin C
degeneration. Because some of • 400 international units of vitamin E
• 15 milligrams of beta-carotene
the vitamin levels used in the study • 80 milligrams of zinc (as zinc oxide)
• 2 milligrams of copper (as cupric oxide)

“As a grandmother of five, I became

concerned when I was having problems
reading to my grandchildren. I made an
appointment with my eye doctor, who
diagnosed me with macular degenera-
tion. Thanks to the treatment and low
vision rehabilitation, it is slowing the
progression of the disease, helping me
use my remaining vision, and allowing
me to enjoy more of this precious time.”
How is macular What treatment
degeneration diagnosed? options are available?
Macular degeneration is diagnosed There is no FDA-approved treatment
by a complete eye examination by an for dry macular degeneration at
ophthalmologist. Testing can include: this time. However, your eye doctor
• Visual acuity testing may be able to treat wet macular
• Tonometry degeneration to slow its progression.
• Amsler grid Photo-dynamic therapy is a process
• Color vision testing that uses laser light to seal leaking
• Retinal examination blood vessels. In this treatment,
the patient is injected with a photo-
reactive compound, which travels
“While there’s no
throughout the bloodstream. A laser
cure for macular
light aimed at the eye causes the
degeneration,
compound to react, sealing the
early detection
leaking blood vessels. This treatment
and intervention
is typically done on an outpatient
is key. Make
basis and may require follow-up visits
sure to visit
to completely seal the vessels. Other
your eye
promising treatments for wet macular
doctor
degeneration include FDA-approved
annually.”
Macugen and Lucentis. Macugen and
Lucentis, prescription injections, work
by blocking a protein that promotes
blood vessel growth.
How can low vision
rehabilitation help me?
While central vision can be greatly
affected by macular degeneration,
good peripheral vision almost always
remains. Low vision professionals
are a part of your plan of care if
you are losing your vision due
to macular degeneration. Your
doctor’s early referral for low vision
rehabilitation can help minimize
the negative impact of vision loss
on daily life. This process begins
with a low vision optometric exam to
determine the nature of your vision
impairment. When the assessment
is complete, the doctor will suggest a
plan of care that may include use of
optical devices, adaptive aids and an
individualized low vision rehabilitation
plan to help make the most of your
existing vision.